On October 4, 2024, the Centers for Medicare & Medicaid Services released its proposed Notice of Benefit and Payment Parameters for 2026. This annual rule governs core provisions of the Affordable Care Act, including operation of the health insurance Marketplaces, standards for health plans, health insurance subsidies, insurance brokers, and the risk adjustment program. This expert perspective focuses on provisions of the rule of interest to state officials. The proposed 2026 NBPP includes proposals related to improving program integrity, supporting improved plan choices, improving consumers' Marketplace experience, setting user fees, and clarifying Basic Health Program payment methodology.